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About Low Level Lasers
History The first working laser was presented to the public at a press conference in 1967 by Theodore Maiman. He demonstrated a ruby laser. The potential for using lasers for surgery was soon explored and rapidly introduced into surgical suites in many countries throughout the world. A Hungarian physician named Endre Mester in Semmelweis University performed cancerous tumor treatment experiments on rats utilizing laser. He found that because it was underpowered for that purpose, the laser he was using didn’t kill tumor cells but, instead, accelerated wound healing in the surgical sites of the experimental rats.¦ He is the grandfather of photobiomodulation since he was the first to observe the healing effects of low powered lasers. Clinical applications How Low Level Lasers Work The Technology Behind How It Works! There have been numerous scientific studies and research articles that discuss different aspects of LLLT or Low Level Laser Therapy and LED biostimulation, each with their own unique perspective. The simplest explanation about how it works is this: :'Photonic Energy (Light) produced by the laser or LED is absorbed by the skin and cells of the body, the Photonic Energy (Light) is converted into chemical energy which initiates a cascade of events at a cellular level. ' LLLT promotes healing in many conditions because it penetrates the skin, increases the and activates enzymes in the targeted cells. *Growth factor response within the cells and tissue as a result of increased and protein synthesis. *Improved cell proliferation *Pain relief as a result of increased endorphin release. *Strengthening the immune system response via increasing levels of lymphocyte activity. [Sourcehttp://www.lifelinelaser.com/the-technology/] 'Two major theories as to why soft lasers work. ' 1. Wolbarsht* postulates that cells are largely dependent for healthy function on an exchange of energy and 'information' with surrounding cells. This is achieved via individual wave systems by which cells 'communicate' through inter-connective plasma. A cell is in an unhealthy state when its vibrations become irregular or out-of-step with this common communications system. Because soft tissue and fluids in our bodies vibrate at a similar frequency to that of some cold-beam lasers, bodily cells be brought back into harmony by being irradiated with soft laser working at a quantum level.---- The effects of Soft Laser Therapy on cell frequency 2. Popp, in one of his seminal works, postulated that all living tissue, at a cellular level, emits ultra-weak photons (light) originating from the body’s electromagnetic field with a surprisingly high degree of laser coherence characteristics. Popp asserts that cells are in a "sick" or pathological state by being enzymatically "light starved". When unhealthy cells were irradiated with soft laser light in the correct frequency range, they once again became "light restored" and healthy. The amazing ability of soft lasers to restore energy, or photons/electrons to the cell, which causes an acceleration of wound healing and tissue regeneration, is why scientists and physicians have been studying the benefits of soft laser therapy for over 30 years. Laser therapy began to be utilized in Eastern Europe in the early 1960's. Since then, scientists all over the world have conducted thousands of studies and clinical trials on the use of laser therapy both in vivo and in vitro. While the majority of studies have concentrated on the biological, practical effects of laser therapy, many have attempted to explain the photo-biological methods behind the results. An interesting theoretical model has to do with the increased production of ATP (adenosine triphosphate), observed in many clinical trials. ATP acts as fuel for the cell and is produced by the mitochondrion, often referred to as the power plant of the cell. The mitochondrion has an inner membrane of large relative area, folded into a very tiny space. The surface of the membrane is packed with mushroom-shaped antenna-pigments that are receptive to photon energy – light. The mitochondrion utilizes this photon energy and transforms it into another kind of energy: ATP Laboratory studies have shown that skin cells grow 150-200 percent faster when exposed to certain LED light wavelengths! David Gawain, [http://www.laserscenarfusion.com/index.html Transformational Health Systems] Biochemical and Biophysical Effects of Low Level Laser Irradiation MAL 2000, Helsinki, Finland 'Levon V. Gasparyan ' Currently the low level laser irradiation (LLLI) is widely applied in different branches of medicine. Several hypotheses are proposed to explain the mechanisms of low level laser therapy (LLLT). But unfortunately the mechanisms of positive influence of LLLI on the affected organism are not still completely understood. Various local and systemic medico-biological processes are take place at the ill organism under the influence of LLLI. The action of laser light of optimal parameters has normalizing influence bringing to the total rising of adaptive potential of the organism and to the acceleration of treatments.   Initial phase of any biological and clinical effect of LLLI is the absorption of a quantum of energy by biotissues with induction of primary photophysical and photochemical processes. A process of absorption is depended for both from optical properties of biological object, and from parameters of laser irradiation.   Ultraviolet, visual and infrared spectra radiations have biological activity. Photophysical processes lies in a basis of the photochemical reactions under the light influence. The potochemical reactions later cause the photobiological actions developing in an organism. The photophysical reactions are mainly determined by warming of the object to different degree (within the limits of 0.1-0.3°Ñ) and diffusion of heat in biotissues. The photochemical reactions are stipulated by exaltation of electrons in atoms of substance absorbing laser light. On molecular level it is expressed by photoionization of matter, its reduction or photooxidation, photodissociation of molecules, and in their rearrangement - photoisomeric change.    The next step of interaction between laser light and organism is the development of the whole body positive reactions. Such reactions are used in LLLT for treatment. It was shown that the clinical effects of LLLI are connected with two maim processes. First of all, with a resonance absorption of light quantums by one or another molecules of chromophores (primary "acceptors"), and secondly with non-resonant thermal absorption of energy by biological molecules and water. The non-resonant absorption of energy caused local heating of macromolecules and membranous structures resulting in conformational changes and accordingly to modification of their function. The temperature difference is more expressed in biological membranes, that to lead the outflow of Na+ and K+ ions from the cells, opening of protein canals and increase of the transport of molecules and ions.    The laser radiation causes heterogeneity of a temperature profile in biological tissues in consequence of irregular distribution of absorptive centers (biological membranes, proteins, ions in solution etc.) in tissues and cells. Such irregularity can substantially influence to metabolic processes in tissues and cells, since results in deformation of cellular membranes, and also in change of their electropotentials. The efficacy of LLLI influence on biotissues can be evaluated at microdeformations value of cellular membranes or change of membrane potentials. These values are determined by gradient of temperature, which one, in turn, depend on the difference of absorption coefficients for laser radiation in near-membrane areas. This implies, such parameters of radiation as polarization and coherency do not influence on efficacy and final effect of irradiation. The essential parameter appears to be a wavelength of radiation. Last is connected with an unequal spectral course of absorption coefficients of different substances, which are heterogeneously distributed in biotissues. In such treating the main advantages of laser light sources above all remaining become understandable: high spectral density and monochromaticity, which under condition of difference of absorption coefficients of different microstructures in biotissue ensure the high contrast of heterogeneity of a temperature profile. The dependence of biostimulation character on monochromaticity and non-importance of coherency and polarization of radiation was noted by several explorers.   M. A. Kaplan (1997) has notified about the marked biological influence of lasers of different wavelengths. The stimulative effect is marked for irradiation of red light (630 and 640 nm). Under influence of blue (470, 480 and 490 nm) and yellow - orange (570 and 580 nm) light spectra the suppression of function activity of irradiated biological objects is take place. Other explorers find biological activity of radiation of the helium - cadmium laser with wavelength 441 nm, nitrogen laser with wavelength 337 nm. Biostimulative activity of green (500 nm) and violet (415 nm) light are also displayed. Enriching of blood microcirculation is detected under action of the gallium arsenide semiconductor laser (890 nm). The intensifying of biostimulative effects is revealed under combined influence of LLLI with the different spectral characteristics, in particular, under irradiation of red and blue laser light.    N. F. Gamaleya supposed that the biological effects of LLLI are connected with natural processes of light regulation observed for animal. The mechanisms of similar processes are better studied on plants, for which not only facts of light-regulation, but also chemical nature of one of primary acceptors of light - phytochromes are established. On the principle about existence of animal photo-regulatory system, similar to phytochrome system of plants, it was suggested that biostimulative activity of radiation of the helium-neon laser is a consequence of coincidence of its spectral characteristics with bands of absorption of components of this system.    The spectral dependence of bioeffect of different tested biological objects is congruent with the usual absorption spectrum of porphyrin compounds being a constituent of many relevant biochemical components of an animal organism - hemoglobin, cytochromes, series of enzymes (catalase, superoxide dismutase) etc.   S. M. Zubkova (1987), G. E. Brill (1992) considered, that molecules of enzymes of antioxidant protection system can appear as primary acceptors of energy of HeNe laser irradiation. They thought about enzymes catalase which contains ferroprotoporphirin coferment complex, and superoxide dismutase (SOD) which contains a metal with variable valency (Cu2+, Zn2+ or Mn3+), strongly bound with protein. Both enzymes have absorption bands near 633 nm. The enhancement of activity of a catalase and SOD as a result of an irradiation by red light positively influences on antioxidant system of organism, results in decreasing the level of lipids peroxide oxidation with the subsequent physiological effects at numerous diseases.    T. I. Karu (1989, 1994) proposed a hypothesis about interaction of LLLI with the respiratory chain components. She considered that, chromophores of HeNe laser light could be cytochromes a and à3 and cytochrome oxidase. The mechanism of activity of LLLI within the framework of this hypothesis includes such sequence of events:  1) At hypoxia under oxygen deficiency conditions the reduction of enzymes - respiratory chain transmitters and decrease of transmembrane potential of mitochondria are take place.  2) LLLI results in reactivation of these enzymes (for example, cytochrome oxidase), that restores a flow of electrons in the respiratory chain and shapes transmembrane potential of mitochondria.   So increase of transmembrane potential in mitochondria, augmentation of production ATP in cells, activation of transport Ñà2+ are take place. The augmentation of ATP production and Ñà2+ ion concentration in the cell result in stimulation of endocellular processes.   G. I. Klebanov et al. (1998) have formulated a hypothesis about the photodynamic mechanism of LLLI activity. The main points of the hypothesis can be presented as follows:   1. Chromophores for laser irradiation in red spectrum are the endogenous porphyrins, which are well known as photosensitizers. The content of porphyrins in an organism increases at many diseases and pathologic conditions not only in cell membranes but also in the blood plasma.   2. The porphyrins, absorbing energy of low level laser light, provoke photosensitized free-radical reactions, including lipid peroxide oxidation of cell membranes, so the amount of free forms of oxygen is growth. It leads to an increase in ionic permeability, including of Ñà2+ ions, across the leukocyte membranes. The content of Ñà2+ ions in extracellular volume is 3-4 degrees higher, than inside cells. Therefore small modification results in passing in the Ñà2+ ions from the extracellular space.   3. The increasing of the Ñà2+ ions content in cytosol of leukocytes starts Ñà-dependent processes leads to the priming of leukocytes. The essence of the priming phenomenon is that the interaction of leukocytes with any stimulant at a very low concentration which does not lead to the immediate activation of the cells still ends with an increase in the functional potential of the leukocytes. A manifestation of the increase is that the response of the cells to the subsequent stimulation at a normal concentration of another stimulant increases several times after this interaction.  4. Rising of the level of functional activity of the cell results in increase of production of different biologically active molecules (nitric oxide, superoxide anion-radical, hypochlorite ion, etc.). Some of them have bactericidal effect, and are also capable to influence microcirculation of the blood. The inducible NO-synthase appears in leukocytes, that results in synthesis of NO in leukocytes. This molecule is the precursor of so-called endothelium derived relaxing factor (EDRF) - which results in vasodilation and improvement of microcirculation contributes to the acceleration of the stage of reperfusion, which is the basis for the most favorable clinical effects of laser therapy.    There is also a suggestion, that because oxygen has the absorption band near 640 nm, it actively absorbs red light, turns into singlet state and initiates oxidative processes in tissues. Examinations on human erythrocytes prove, that near infrared spectrum LLLI (700-900 nm) influences the deformability of the erythrocyte membrane. The mechanism of influence concludes the origination of primary damages of cytoplasm membrane by singlet oxygen generated as a result of a photoexcitation of molecular oxygen, having absorption bands near 586, 640,762, 1060 nm.    It is necessary to pay attention to that fact, that all the examined above candidates for the role of primary acceptors of LLLI are not specific regulators of cell functions and their activation under laser irradiation cannot explain the integrated response showing in coordinated changes of many parameters of metabolism and functions of both cell and whole body levels.    The laser light has positive influence on living cells and organisms at different pathologies. Is it possible that the basically outer regarding biosystem physical factor appear as the treating or normalizing factor? It is rather difficult to imagine. It is more logical to suspect that the outer physical factor works through the inner regulatory system of cells and organism, optimizing their operation and function. Such inner regulatory system, according to G. E. Brill (1997, 1999) could be the system of guanilate cyclase - cyclic guanosin monophosphate - NO-synthase. It is an indivisible system. The activation of a NO-synthetase results in an activation guanilate cyclase and further accumulation of cyclic guanosin monophosphate (cGMP).   Guanilate cyclase catalyzes a biosynthesis of cGMP. The porphyrin complex (heme) having an atom of Mn instead of Fe one is the prosthetic group of guanilate cyclase molecule. The presence of the porphyrin complex in the structure of guanilate cyclase makes possible its absorption of red light quantums.   The indirect evidence of probable participation of guanilate cyclase - cGMP system in realization of LLLI bioeffects is detected under certain conditions similarity of final effects of LLLI influence and guanilate cyclase - cGMP system activity. The cGMP effects includes vasodilation; stimulation of mitotic activity of cells, promotes an acceleration of an adhesion of wounds; and also delay of thrombocytes aggregation. The similar effects are registered under HeNe laser action too.   NO is created in cells with the participation of NO-synthase enzyme. The prosthetic group of that enzyme contains compounds, which are capable to absorb red light photons. Endogenous NO activates guanilate cyclase as a result of interaction with heme. G. E. Brill (1997) suggested that the work of such photosensitive system could be connected with changes of intracellular level of cGMP. The cGMP molecule is a universal trigger molecule participating in transmission of photosignals both in specialized retinal cells, and in cells, not having specific photoreceptors.   It was shown that the preliminary introduction of cGMP in cells takes out boosting effects of red light. It is very important the direct measurements indicated the rising of the content of cGMP in thrombocytes under HeNe laser irradiation.    Thus, the mechanisms of action of low level laser irradiation in visual and infrared spectra on cells, tissues an organism as a whole include the processes taking place on cellular and molecular levels.    Summarizing data of the modern studies, LLLI causes activation of energy synthesis processes in pathologically changed tissues with insufficiency of metabolism, increase of activity of main enzymes, reduction of oxygen consumption by tissues with simultaneously rising of mitochondria activity, rising of intensity of glycolysis in tissues and other.   The secondary effects are the complex of adaptive and compensatory responses appearing as a result of resulting realization of primary effects in tissues, organs and the organism as whole. Among these responses it is necessary to mark the following:  1) Activation of a metabolism of cells and rising of their function activity;   2) Stimulation reparation (restoration) processes;  3) Antiinflammatory activity;   4) Activating of blood microcirculation and rising the level of trophic supply of tissues;   5) Analgetic activity;   6) Immunostimulative activity;   7) Reflex influence on functional activity on different organs and systems;   8) Rising of oxygen blood level.    The laser therapy is inherent features of the justified pathogenic therapy method. At its application it is relevant the count not only general state of the organism, specificity of pathological process, its clinical manifestation, stages and form of diseases, but also associated diseases, age and professional features of the patient. The application of a phototherapy is the most successful in functional and reversible stages of illness, though the new procedures are applied at the treatment of heavier conditions and pathological process, at the presence of expressed morphological changes. Choosing A Laser Treatment Which low level laser is right for you? The FDA has approved many types of cutting laser for both medicine and dentistry. The first low level laser was cleared for myofacial pain in 2001. The FDA classifies all lasers, whether they are industrial or medical, according to their radiation hazard on the eye as Class 1, 2, 3, or 4 with subdivisions of some of the classes. The Radiation hazard classification is not difficult to obtain, however the FDA also requires lasers used for treating humans to be classified under the Medical Devices Division. Getting the laser classified here is much more difficult because the FDA requires efficacy, or proof, that that the lasers do work and they do what the manufacture claims, without harming the patient. The Radiation hazard classification is determined by potential risk to the eye. There are several factors that enter into this determination. Collimated means that the laser comes to a point, such as laser pointers, and maintains this beam at distances depending on the power applied. The US military depends on lasers to guide bombs. NASA depends on lasers to guide the spacecraft. To accurately measure a laser for eye risk, the laser-measuring instrument is placed 20 centimeters from the light beam source. If the laser beam is not collimated, but allowed to diffuse, low level lasers are very safe. Low Level Lasers Inc has registered Industrial lasers, the predecessors to the Q1000, which have been classified as Class 1, or a non significant risk, based on testing done by Stoney Brook University and Underwriters Laboratory. Worldwide research has shown benefit from LED’s as well as true laser diodes. LED’S are light emitting diodes, and basically are different colored miniature light bulbs. They are inexpensive and are used extensively in industry. Some companies have made clusters of LED’s for human use. The FDA does not regulate LED’s in the same manner as laser diodes therefore companies can advertise their product as FDA approved. Unfortunately many people are mis-led to believe that these LED’s are lasers and have the same benefit as true lasers. You can learn more about wavelength and power in other lessons. In general a low level laser is considered anything below 1 (one) watt of power regardless of the wavelength. Remember 1 watt is the same as 1000 milliwatt written as 1mW. Wavelengths are measured in nanometers or 1000th of a millimeter written as 1nm. Most low level lasers are in either red visible light in the range of 632 to 670nm or near infrared wavelengths (which can be seen faintly in a darkened room) in the range of 680 to 904nm. Either LED’s or true laser diodes can deliver all these wavelengths. You can tell the difference between LED’s and true laser diodes by: *LED’s are brighter and emit light in a round circle. *LED’s to be effective must be run at higher powers. * LED's do not carry information - they can't check out groceries, print - print or play music *LED’s are much cheaper than true lasers. LED units can be bought all the way from a few dollars on up to $150 to $300 and even more. The actual cost of a single LED ranges from $.15 (cents) up to $.55 therefore clusters of LED’s would only cost the manufacturer a few dollars.On the other hand true laser diodes can be either: *Colluminated and emit light in a small point that travels long distances - these types of lasers are used for laser pointers for lecturing and sometimes for acupuncture. *Non-colluminated laser diodes emit light in a narrow linear band and as you move the laser farther away the band diffuses and becomes difficult to see. This type of laser carries more information than a laser pointer type of low level laser *True laser diodes carry information - they can carry the price of groceries, music, print or when used for healing, when combined to form the soliton wave, they can carry electrons back to damaged cell membranes.All light works to some degree but if you are going bear hunting take along a gun, not a sling shot. Some parts of the body require more energy, different wavelengths, and different frequencies than other parts of the body, therefore one wavelength emitted by a single diode laser, regardless of the power or frequency used will not treat all conditions. When a buyer buys a single wavelength laser, and it takes a long time to get results, they usually become disillusioned with lasers, thinking they don't work, when in reality they are using the wrong laser. The following rules should be applied when using low level lasers: *Resonate bellies of muscles, glands, and organs - this means using a multiple wavelength diode laser (Q1000) that emits less than 5 mW of energy and using a low dose. *Stimulate bone, nerves, ligaments, tendons, and cartilage - this means you can use a single wavelength visible light (660 Enhancer) or infrared light diode laser (808 Enhancer) that delivers a higher dose of energy which stimulates. You will learn more about wavelength, frequency, joules (dose) soliton wave, constructive and destructive frequencies in other lessons on the Laser Learning Center videos. There are over 26 companies that sell some type of therapeutic low level laser in the United States. There is no Consumer Index or Good Manufacturing Guidelines to use when buying a low level laser so it is pretty much “buyer beware”. The following guidelines and information will be helpful when choosing a low level laser. First, let me tell you that all light works at least to some extent, but there is a lot of over zealous advertising. Some companies are actually advertising that they have the only wavelength that is beneficial. Choose a reliable company. Questions to ask: *How long has the company been in business? 90% of all laser companies go out of business within a few years. Is the company a US or foreign company – many foreign made lasers are illegally brought into the US and the companies are subject to being closed down because they are in violation of US Government regulations. Furthermore it is difficult to get foreign lasers repaired. Does the company have its lasers registered with the FDA for safety? Has the laser company done any clinical research to prove their laser’s effectiveness for the diseases they are claiming to treat? How long does it take to get your laser delivered once ordered? What is the company warranty policy? How long does it take to get repairs? Does the company have a separate escrow or trust account to back up the warranty in case the company goes out of business? Most companies say they have a warranty but is the warranty any good? *Other things to know that will be discussed elsewhere on this web site are wavelength - frequency – power - power density – soliton wave - Penetration – combination wave lengths versus single waves lengths - “pseudo-science” in the laser business – dose or joules. Remember, Results are directly related to the dose Ease of use and Training is very important Is qualified professional support readily available? A doctor trained and experienced in low level lasers MUST be available for the user to call when the results are not satisfactory. *And finally, price should not be the main determining factor when buying a laser. You get what you pay for. The factors just discussed are more important than price. Dr. Lytle: [http://www.qlaserhealinglight.com/choosinglaser.html http://www.qlaserhealinglight.com/choosinglaser.html] Low Level Lasers in Medicine Low Level Laser Therapy Physical therapy is one of the most ancient methods of medical treatment. Historically such factors as air, sun and water were used everywhere, then, gradually, with the deeping knowledge about environment and world this arsenal grew. In addition to natural, artificial action sources, electrical and electromagnetic fields, optical radiation, mechanical and temperature factors have come into use. The discovery in 60-s of the possibility of intensify light by stimulated radiation results in the creation of lasers, which found immediate application in medicine. In 1974 the Ministry of Medical Care of the USSR gave permission for clinical use of the first device for laser therapy. So the Low Level Laser Therapy (LLLT) is one of the latest developments of the phototherapy. During the last 20 years laser therapy has received wide recognition in medical practice and has occupied a stable important position among the medical physical factors used before. The range of laser applications is so wide that sometimes the question of separation of this method into an independent branch of medical science arises. If up to mid 80-s red HeNe laser (632.8 nm) was actively studied and used in clinical practice, during the last ten years, red (630 - 670 nm) and infrared (830 - 1300 nm) laser diodes have been widely applied, which is explained by their small size, simple maintenance, long service life, economy and rather high clinical efficiency. Blue and ultraviolet lasers find their application too, especially for fighting infections. Low level laser blood irradiation (LBI) is one of the most perspective methods of low level laser therapy. LBI is used in the therapy of several disorders. LBI had several positive effects, such as antiinflammatory effect, activation of immune system, protection of vessels, improvement of blood microcirculation and tissue trophic processes, activation of regeneration and reparation (Sirenko et al. 1992). Better state of vascular wall, atherosclerotic plaque size reduction, improvement in blood microcirculation were observed among patients with atherosclerotic vascular disease after transcutaneous infrared (IR) LBI (Kaplan et al. 1997). Some scientists considered as a key importance problem determination the most appropriate methods of applying laser energy, dosage. In the same time some Russian scientists (Karu, Drill, Klebanov) considered as the most important factor the wavelength of light and main photo-acceptor molecule or structure. They argued that laser light and non-coherent light of same wavelength and power density have the same biological and medical effects. It was shown that different spectra light have approximately the same influence on then organism. For example, Samojlova (1998) compared results of photo-modification of blood under HeNe intravenous and UV extra-corporate irradiation. She reported that changes in blood cells after UV irradiation were very close but not completely similar to changes discovered after HeNe blood irradiation. Other scientists reported that the clinical effects of HeNe and IR laser irradiation are also the some. Kapustina (1997) reported that 3 main groups of patients according to the response to LBI were detected. The first group patients had immediate in vitro (within 15 min.) positive changes in the state of erythrocyte membranes under LBI, the second group patients had postponed response, and the third group patients had no response at all. Clinical (in vivo) studies proved, that the first group patients showed better and faster treatment results. For the second group patients more sessions of LBI were required to achieve therapeutic results. No therapeutic effects were discovered for group 3 patients. Several studies emphasized that laser effects were detected in the case of irradiation of damaged cells and organisms. In the case of irradiation of normal and healthy organisms very slight or no changes at all were registered. The influence of low level laser irradiation on the organism has several clinical effects, including anti-inflammatory, immune stimulating, neurotrophic, analgesic, desensitizing, bactericidal, antiedemic, normalizing the blood rheology and hemodynamics effects. So the areas of application of LLLT are very large and include almost all branches of medicine: *Cardiology - ischemic heart disease, stenocardia, myocardial infarction; *Otorhinolaryngology - pharyngitis, tonsillitis, maxillary sinusitis, tracheitis, otitis; *Gastroenterology - gastritis, stomach ulcer and duodenal ulcer, cholecystitis, pancreatitis, hepatitis, colitis; *Dermatology - dermatitis, dermatosis, neurodermite; *Pulmonary diseases - bronchial asthma, pneumonia, pleuritis; *Gynecology - mastitis, inflammations, erosions, generic and postnatal complications; Urology - adenoma, prostatitis, cystitis, urethritis, nephritis, pyelonephritis, urolithic disease; *Proctology - hemorrhoids, periproctitis, anal pruritus and fissures; *Neuropathology - neuritis of upper and lower extremities, radiculitis, neuralgia of the head and face; *Arthrology - diseases of joints and vertebral column; *Stomatology - caries, pulpitis, periodontitis, paradontitis. In the near future more studies about the influence of different wavelength laser light on the organism, the most appropriate dosage of laser irradiation would be done. As a result probably the mechanisms of laser therapy would be more understandable, as well as the methods of forecasting the clinical effects of laser irradiation would be development. [Source:http://www.geocities.com/lgasparyan/lllt_e.html] Intravenous Laser Blood Irradiation Therapy Currently the methods of laser and non-laser (incoherent monochromic, narrow-band or broadband) light blood irradiation therapy - the methods of photohemotherapy - are widely applied in the treatment of different pathologies. Direct intravenous and extracorporeal (with red, UV and blue light) as well as transcutaneous (with red and infrared light) irradiation of blood are used. Unlike the treatment mechanisms of procedures of local laser therapy, the medical effects of photohemotherapy methods are determined by predominance of systemic healing mechanisms above the local ones, increasing the efficacy of functioning of vascular, respiratory, immune, other systems and organism as a whole. The method of HeNe intravenous laser blood irradiation (LBI) was developed in experiment and introduced in clinic in 1981 by soviet scientists E.N. Meshalkin and V.S. Sergievskiy. Originally the method was applied in the treatment of cardiovascular pathologies. Some authors reported that the treatment possibilities of the method are very large and include the improvement of rheological characteristics of the blood and microcirculation, normalization of parameters of hormonal, immune, reproductive and many other systems. HeNe laser (632.8 nm) is generally used for carrying out the intravenous laser blood irradiation (IV LBI). Usual parameters of blood irradiation procedure are: output power at the end of the light-guide inserted into a vein from 1 up to 3mW, exposition 20 - 60 minutes. Procedures are conducted on a daily base, from 3 up to 10 sessions on a course of therapy. It was shown, that IV HeNe LBI stimulates the immune response of the organism, activates erythrogenesis and improves deformability of erythrocyte membranes, has anti-hypoxic activity on tissues and general antitoxic influence on the organism at different pathological processes. IV LBI is used for its biostimulative, analgetic, antiallergic, immunocorrective, antitoxic, vasodilative, antiarrhythmic, antibacterial, antihypoxic, spasmolytic, anti-inflammatory and some other properties. IV LBI activates nonspecific mechanisms of anti-infectious immunity. Intensifying of bactericidal activity of serum of the blood and system of the complement, reduction of the degree of C - reactive protein, level of average molecules and toxicity of plasma, increasing the content of IgA, IgM and IgG in the serum of the blood, as well as decreasing of the level of circulating immune complexes are proved. There are studies on boosting effect of IV LBI on the cellular part of immunity (N. F. Gamaleya et al., 1991). Under influence of IV LBI the phagocytic activity of macrophages markedly increases, concentration of microbes in exudate in the abdominal cavity of patients with peritonitis decreases, reduction of inflammatory exhibiting of disease, activation of microcirculation are detected. The medical effect of IV LBI is stipulated by its immuno-corrective activity by normalization of intercellular relationships within the subpopulation of T-lymphocytes and increasing the amount of immune cells in a blood. It elevates the function activity of B-lymphocytes, strengthens the immune response, reduces the degree of intoxication and as a result improves the general condition of patients (V. S. Sergievskiy at al., 1991). IV LBI promotes improving the rheological properties of blood, rising fluidity and activating transport functions. That is accompanied by increasing the oxygen level, as well as decreasing the carbon dioxide partial pressure. The arterio-venous difference by oxygen is enlarged, that testifies the liquidation of a tissue hypoxia and enrichment the oxygenation. It is a sign of normalization of tissue metabolism. Probably, the basis of activation of oxygen transport function of IV LBI is the influence on hemoglobin with transforming it in more favorable conformation state. The augmentation of oxygen level improves metabolism of the organism tissues. In addition, the laser irradiation activates the ATP synthesis and energy formation in cells (A. S. Krjuk et al., 1986). Application of IV LBI in a cardiology has shown that procedures have analgetic effect, show reliable rising tolerance of patients towards physical tolerance test, elongation of the period of remission. It was proved that IV LBI reduces aggregation ability of thrombocytes, activates fibrinolysis, which results in peripheral blood flow velocity increasing and tissues oxygenation enriching. The improvement of microcirculation and utilization of oxygen in tissues as a result of IV LBI is intimately linked with positive influence on metabolism: higher level of oxidation of energy-carrying molecules of glucose, pyruvate, and other substances. The improvement in microcirculation system is also stipulated by vasodilation and change in rheological properties of blood as a result of drop of its viscosity, decrease of aggregation activity of erythrocytes due to changes of their physicochemical properties, in particular rising of negative electric charge. Finally the activation of microcirculation, unblocking of capillaries and collaterals, improvement of tissue trophical activity, normalization of a nervous excitability are take place (N. N. Kapshidze et al., 1993). IV LBI is recommended to apply before surgical operations as preparation for intervention, as well as in the postoperative stage, because the laser irradiation of blood has not only analgetic effect, but also spasmolytic and sedative activity. IV LBI procedures on patients with chronic glomerulonephritis allow overcoming resistance towards medicament therapy (glucocorticoid, cytostatic, hypotensive and diuretic drugs). IV LBI promotes rising of concentration of antibiotics in the focus of inflammation as a result of improvement the microcirculation in the focus of inflammation, as well as normalization the morphology and functional activity of the affected organ as a whole. IV LBI procedures have found broad application in obstetrics and gynecology for activation the blood flow in utero-placental and feto-placental basins, for prophylaxis the pathology at delivery, for influence on inflammatory processes of inner genital organs. IV LBI normalizes production of gonadotropins, improves microcirculation, elevates oxygen pressure in blood and in tissues, and so accelerates the process of regeneration and reparation. In order to explain the generalized and multifactor effects of IV LBI, its positive influence practically on all tissues and functional systems of the body, clinical effectiveness for the treatment of different diseases, some authors mentioned that the improvement of microcirculation after IV LBI is detected in all structures of central nervous system, but this improvement the most active in the hypothalamus, which has highly developed vascular system. The capillaries of a hypothalamus are remarkable for high permeability for macro-molecular proteins, which should even more amplify influence of the irradiated blood to subthalamic nuclei. So it is supposed, that IV LBI increases the functional activity of hypothalamus and all limbic system, and as a result the activation of energetic, metabolism, immune and vegetative responses, mobilization of adaptive reserves of an organism is reached. Transcutaneous Laser Blood Irradiation Therapy The application in clinics of the non-invasive and relatively simple method of infrared (IR) transcutaneous laser irradiation of blood becomes possible after development of suitable IR semiconductor laser diodes. For transcutaneous LBI lasers with red (630-670 nm) or near IR (800-1300 nm) irradiation band are applied. Laser light is delivered to the skin on a projection of large veins or arteries via special nozzles. Some recent studies suggested that it is possible to achieve the medical effect similar to effect of IV HeNe LBI, without intravenous manipulations - by transcutaneous laser blood irradiation (TLBI). The procedure of TLBI have the greatest application in children's practice. The method grounded on a relatively high permeability of the skin and hypodermic tissues for radiation of red and especially of IR spectrum. It is supposed, that the efficacy of 20 mW HeNe laser transcutaneous blood irradiation is equal to 1 mW HeNe laser intravenous blood irradiation. In the same time TLBI procedures are non-invasive and painless. Recently non-laser light sources are also applied for transcutaneous blood irradiation. Unfortunately, there are not enough qualified works on comparing medical and biological effects of IV and transcutaneous LBI to make the final suggestions about clinical equality of these methods. At the same Е. Brill (1994) suggested that the effects of the laser therapy depend on the method of irradiation. He considered, that the term «transcutaneous laser blood irradiation» is disorient the explorer, as skips the significance in definition of bioeffect of irritation of receptors of the skin and acupuncture points, dermal cells (including mast cells), adventitious elements of the vascular wall and other formations which are subject to the irradiation. For today there are no bases to consider, that the positive therapeutic effect of laser irradiation of skin - is a result of influence only of that part of energy, which penetrates the skin and is absorbed by blood and its components. With the good reasons it is possible to speak about transcutaneous laser irradiation, with indication of the place of delivery of laser light. [Source:http://www.geocities.com/lgasparyan/lllt_e.html] Other Names For Low Level Laser Therapy Regarding the therapy, we have chosen to use the term LLLT (Low Level Laser Therapy). This is the dominant term in use today, but there is still a lack of consensus. #'Deep penetrating light therapy (DPLT) '' #'''Low Power Laser Therapy (LPLT) ' #'Cold Laser Therapy #'Soft Laser Therapy' #'Photobiomodulation' #'Laser biostimulation' #'Light Therapy or Phototherapy' http://en.wikipedia.org/wiki/Light_Therapy In the literature LPLT (Low Power Laser Therapy) is also frequently used. Regarding the laser instrument, we have chosen to use the term "therapeutic laser" rather than "low level laser" or "low power laser", since high-level lasers are also used for laser therapy. The term "soft laser" was originally used to differentiate therapeutic lasers from "hard lasers", i.e. surgical lasers. Several different designations then emerged, such as "MID laser" and "medical laser". "Biostimulating laser" is another term, with the disadvantage that one can also give inhibiting doses. The term "bioregulating laser" has thus been proposed. An unsuitable name is "low-energy laser". The energy transferred to tissue is the product of laser output power and treatment time, which is why a "low-energy laser", over a long period of time, can actually emit a large amount of energy. Other suggested names are "low-reactive-level laser", "low-intensity-level laser", "photobiostimulation laser" and "photobiomodulation laser". "LPT - Laser Photo Therapy" is a recentlysuggested term, and winning acceptance. Thus, it is obvious that the question of nomenclature is far from solved. This is because there is a lack of full agreement internationally, and the names proposed thus far have been rather unwieldy. Feel free to forget them, but remember LLLT until agreement is reached on something else. [http://www.laser.nu/lllt/Faq1.htm#Is%20laser http://www.laser.nu/lllt/Faq1.htm#Is%20laser] See also